The Scapula: MMT Flashcards

0
Q

Scapula ABD & UPWARD ROTATION

Grade 2

A

Patient Position:
Short sitting
Arm flexed above 90*

Therapist Position:
Stand at test side
Hand supporting elbow
Other hand at edge of inferior angle of scapula

Test:
Monitor scapula motion by using light grasp on scapula at inferior angle (look for winging)

Instructions:
“Hold your arm in this position. Let it relax. Now hold your arm again. Let it relax.”

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1
Q

Scapula ABD & UPWARD ROTATION

Grades 5, 4, 3

A

(Serratus Anterior)

Patient Position:
Short sitting

Therapist Position:
Stand at test side
Resistance on arm proximal to elbow
Other hand at edge of inferior border of scapula

Test:
Patient raises arm to 130* flex with elbow ext

Instructions:
“Raise your arm forward over your head. Keep your elbow straight, hold to. Don’t let me push you down.”

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2
Q

Scapula ABD & UPWARD ROTATION

Grades 1, 0

A

Patient Position:
Short sitting
Arm flexed above 90*

Therapist Position:
Standing in front and slightly to the test side
Hand supporting arm at elbow
Other hand at edge of inferior angle of scapula

Palpations:
-Serrarus Anterior: tips of fingers just in front of the inferior angle along Axillary border

Test:
Patient attempts to hold the arm in test position

Instructions:
“Try to hold your arm in this position.”

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3
Q

Scapular ELEVATION

Grades 5, 4, 3

A

(Upper Trapezius)

Patient Position:
Short sitting
Hands relaxed in lap

Therapist Position:
Stand behind patient
Hands over both shoulders
Resistance in a downward direction

Test:
Patient elevates shoulders

Instructions:
“Shrug your shoulders. Hold it. Don’t let me push them down.”

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4
Q

Scapula ELEVATION

Grades 2, 1, 0

A

Patient Position:
Prone or supine

Therapist Position:
Stand on test side
Support shoulder with palm of one hand

Palpations:
-Upper Trapezius: just adjacent to cervical spine

Test:
Patient elevates shoulder to ear

Instructions:
“Raise your shoulders toward your ears.”

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5
Q

Scapula ADD

Grades 5, 4, 3

A

(Middle Trapezius & Rhomboid Major)

Patient Position:
Prone with shoulder at edge of table
Shoulder ABD to 90*
Elbow flexed to 90*

Therapist Position:
Stand at test side
-if post delt is grade 3 or better place resistance over distal humerus
-if grade 2 or less place resistance over shoulder joint

Stabilization:
Contralateral scapula area: to prevent trunk rotation

Test:
Patient horizontally ABD’s arm and ADD’s shoulder

Instructions:
“Lift your elbow toward the ceiling. Hold it. Don’t let me push you down.”

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6
Q

Scapula ADD

Grades 2, 1, 0

A

Patient Position:
Prone w/ shoulder at edge of table
Shoulder ABD to 90*
Elbow flexed to 90*

Therapist Position:
Stand at test side
One hand cradles shoulder/arm

Palpations:
Spine of scapula from Acromion to vertebral column

Test:
Patient horizontally ABD’s arm and ADD’s shoulder

Instructions:
“Lift your elbow toward ceiling.”

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7
Q

Scapula DEPRESSION & ADD

Grades 5, 4, 3

A

(Lower Trapezius)

Patient Position:
Prone with test arm over head to ab 140* ABD
Thumb pointing to ceiling

Therapist Position:
Stand at test side
Resistance over distal humerus

Test:
Patient raises arm from table to at least ear level

Instructions:
“Raise arm from table as high as possible. Hold it. Don’t let me push it down.”

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8
Q

Scapula DEPRESSION & ADD

Grades 2, 1, 0

A

Patient Position:
Prone with test arm over head to ab 145* ABD
Thumb pointing to ceiling

Therapist Position:
Stand at test side
Support patients arm under elbow

Palpation:
Triangular area btw root of spine and lower thoracic vertebrae

Test:
Patient attempts to raise arm from table
If unable then therapist lifts and supports wt. of arm

Instructions:
“Try to raise your arm from the table as high as you can.”

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9
Q

Scapula ADD & DOWNWARD ROTATION

Grades 5, 4, 3

A

(Rhomboid Major and Minor)

Patient Position:
Prone
Shoulder IR
Arm ADD across back 
Elbow flexed
Hand resting on back

Therapist Position:
Stand at test side
One hand under vertebral border of scapula
Other hand:
-if shoulder ext grade 3 or better: place resistance on distal humerus downward and outward
-if shoulder ext grade 2 or less: places resistance along Axillary border of scapula

Test:
Patient lifts hand off back as resistance is given

Instructions:
“Lift your hand. Hold it. Don’t let me push you down.”

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10
Q

Scapula ADD & DOWNWARD ROTATION

Grades 2, 1, 0

A

Patient Position:
Short sitting
Shoulder IR
Arm extended and ADD behind back

Therapist Position:
Stand at test side
Support arm by grasping the wrist

Palpations:
Muscle under the vertebral border of scapula

Test:
Patient attempts to move hand away from back

Instructions:
“Try to move hand away from back.”

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11
Q

Scapula DEPRESSION

Grades 5, 4

A

(Latissimus Dorsi)

Patient Position:
Prone with head turned to test side
Arms at sides
Shoulders IR
Test shoulder "hiked" to level of chin

Therapist Position:
Stand at test side
Grasp forearm above patients wrist with both hands

Test: patient depresses arm

Instructions:
“Reach your hand toward your feet. Hold it. Don’t let me push your arm upward toward your head.”

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12
Q

Scapula DEPRESSION

Grade 5

(If patient is very strong in the Lats)

A

Patient Position:
Short sitting
Hands flat on table adjacent to hips

Therapist Position:
Stand behind patient

Test:
Patient pushes down on hands and lifts buttocks from table

Instructions:
“Lift your bottom off the table.”

Grade 5 if able to lift buttock off the table

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13
Q

Scapula DEPRESSION

Grades 3, 2

A

Patient Position:
Prone with arms at sides
Shoulders IR

Therapist Position:
Stand at test side

Test:
Patient pushed arm towards feet

Instructions:
“Reach down towards your feet.”

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